Simsir Adnan, Kizilay Fuat, Aliyev Bayram, Kalemci Serdar
Dr. Adnan Simsir, Department of Urology, Ege University School of Medicine, Izmir, Turkey.
Dr. Fuat Kizilay, Department of Urology, Ege University School of Medicine, Izmir, Turkey.
Pak J Med Sci. 2021 Jan-Feb;37(1):167-174. doi: 10.12669/pjms.37.1.2719.
In this study, we aimed to make a comprehensive comparison of the first hundred robot-assisted radical prostatectomy (RARP) and open retropubic radical prostatectomy (RRP) cases of a single surgeon in a high-volume center.
Preoperative, perioperative and postoperative data were collected retrospectively. Perioperative, oncological data and functional results in the first year were compared between the two groups. There were 204 RARPs between January 1, 2014 and December 31, 2019, and 755 RRPs between April 1, 2007 and December 31, 2019.
While the operation time was in favor of the open group (117 vs 188 min, p<0.001), the estimated blood loss (328 vs 150 ml, p<0.001), blood transfusion rate (12 vs 2, p=0.021), and re-operation rate (6 vs 0, p=0.001) were in favor of the robotic group. Mean length of hospital stay (5.4 vs 3.1, p<0.001), urine leak rate (11 vs 2, p=0.033), complication rate (37 vs 16, p=0.018), and the 12th month continence rate (67 vs 85, p=0.002) were better in the robotic group.
RARP may provide better perioperative outcomes and lower complication rates after the surgeon factor is eliminated in the early period. Since our case group includes the initial 100 patients, studies with larger patient groups with longer follow-up are needed to adapt these early results to general outcomes.
在本研究中,我们旨在对一位高手术量中心的单一外科医生进行的前100例机器人辅助根治性前列腺切除术(RARP)和开放性耻骨后根治性前列腺切除术(RRP)病例进行全面比较。
回顾性收集术前、围手术期和术后数据。比较两组在围手术期、肿瘤学数据和第一年的功能结果。2014年1月1日至2019年12月31日期间有204例RARP,2007年4月1日至2019年12月31日期间有755例RRP。
虽然手术时间有利于开放手术组(117分钟对188分钟,p<0.001),但估计失血量(328毫升对150毫升,p<0.001)、输血率(12%对2%,p=0.021)和再次手术率(6%对0%,p=0.001)有利于机器人手术组。机器人手术组的平均住院时间(5.4天对3.1天,p<0.001)、尿漏率(11%对2%,p=0.033)、并发症发生率(37%对16%,p=0.018)和第12个月的控尿率(67%对85%,p=0.002)更好。
在早期消除外科医生因素后,RARP可能提供更好的围手术期结果和更低的并发症发生率。由于我们的病例组包括最初的100例患者,需要对更大患者群体进行更长时间随访的研究,以使这些早期结果适用于总体结果。